<!DOCTYPE html>
<html>
	<head>
		<title>Web form</title>
		<link type="text/css" rel="stylesheet" href="style.css"/>
	</head>
	<body>
		<form>
			<table>
				<colgroup>
					<col style="width:170px"/>
					<col style="width:248px"/>
					<col style="width:45px"/>
					<col style="width:70px"/>
				</colgroup>
				<thead>
				</thead>
				<tfoot>
					<tr>
						<td colspan="4">
							<div>
								<input type="submit" value="Submit" />
								<input type="reset" value="Clear This Form" />
							</div>
							
						</td>
					</tr>
				</tfoot>
				<tbody>
					<tr>
						<td>
							<div><label for="lastName">Last Name</label></div>
						</td>
						<td colspan="3">
							<input type="text" id="lastName" placeholder="Nakov" />
						</td>
					</tr>
					<tr>
						<td>
							<div><label for="firstName">First Name</label></div>
						</td>
						<td colspan="3">
							<input type="text" id="firstName" placeholder="Svetlin" />
						</td>
					</tr>
					<tr>
						<td>
							<div><label for="address">Address</label></div>
						</td>
						<td colspan="3">
							<textarea id="address">17 Hristo Botev Str. floor 3, apt. 12</textarea>
						</td>
					</tr>
					<tr>
						<td>
							<div><label for="city">City</label></div>
						</td>
						<td>
							<input type="text" id="city" placeholder="Kaspichan" />
						</td>
						<td>
							<label for="state">State</label>
						</td>
						<td>
							<input type="text" id="state" class="small" />
						</td>
					</tr>
					<tr>
						<td>
							<div><label for="postalCode">Zip/Postal Code</label></div>
						</td>
						<td colspan="3">
							<input type="text" id="postalCode" placeholder="9325" class="medium"/>
						</td>
					</tr>
					<tr>
						<td>
							<div><label for="country">Country</label></div>
						</td>
						<td colspan="3">
							<select id="country">
								<option selected="selected">---</option>
								<option>Afganistan</option>
								<option>Andora</option>
								<option>Brazil</option>
								<option>Bulgaria</option>
								<option>Burundi</option>
								<option>Canada</option>
								<option>Denmark</option>
								<option>Egypth</option>
								<option>France</option>
								<option>Germany</option>
								<option>Honduras</option>
								<option>India</option>
								<option>Italy</option>
								<option>Jamaica</option>
								<option>Kenia</option>
								<option>Lebanon</option>
								<option>Moldova</option>
								<option>Makedonia</option>
								<option>Norway</option>
								<option>Portugal</option>
								<option>Russia</option>
								<option>Switzerland</option>
								<option>Slovakia</option>
								<option>Slovenia</option>
								<option>Turkey</option>
								<option>Ukraine</option>
								<option>Zimbabwe</option>
							</select>
						</td>
					</tr>
					<tr>
						<td>
							<div><label for="phone">Phone (country code, area code, number)</label></div>
						</td>
						<td colspan="3">
							<span>
								(+<input type="tel" id="phone" class="small" placeholder="359" />)<input type="tel" class="small" placeholder="88" />-<input type="tel" placeholder="8334343" />
							</span>
						</td>
					</tr>
					<tr>
						<td>
							<div><label for="email">E-mail</label></div>
						</td>
						<td colspan="3">
							<input type="email" id="email" placeholder="nakov@kaspichan.org" />
						</td>
					</tr>
					<tr>
						<td>
							<div><label for="month">Birth date</label></div>
						</td>
						<td colspan="3">
							<label for="month">Month</label>
							<input type="text" id="month" class="small" placeholder="06" />
							<label for="day">Day</label>
							<input type="text" id="day" class="small" placeholder="14" />
							<label for="year">Year(4 digit)</label>
							<input type="text" id="year" class="small" placeholder="1980"/>
						</td>
					</tr>
					<tr>
						<td>
							<div><label for="gender">Gender</label></div>
						</td>
						<td colspan="3">
							<select id="gender">
								<option selected="selected">---</option>
								<option>Male</option>
								<option>Female</option>
								<option>Other</option>
							</select>
						</td>
					</tr>
					<tr>
						<td>
							<div><label for="spring">Starting date</label></div>
						</td>
						<td colspan="3">
							<input type="radio" id="spring" name="date" />
							<label for="spring">Spring 2006</label>
							<input type="radio" id="summer" name="date" />
							<label for="summer">Summer 2006</label>
						</td>
					</tr>
					<tr>
						<td>
							<div><label for="comment">Comments/Questions</label></div>
						</td>
						<td colspan="3">
							<textarea id="comment">Please send me more information about the lodging</textarea>
						</td>
					</tr>
				</tbody>
			</table>
		</form>
	</body>
</html>